Risk Factors Affecting Falls among Old Adults in Community: A Systematic Review
Keywords:
Falls, community-dwelling older adults, systematic reviewAbstract
Falls are a marker of frailty, immobility, and acute and chronic health impairment in older persons. This systematic review aimed to provide the best available evidence related to risk factors for falls among community-dwelling older adults. Mixed search methods were used to retrieve English published studies from 2000-2016 through a variety of medical databases. Eligibility criteria specified articles evaluating the association between falls and its risk factors in older adults. A total of 10 studies met inclusion criteria and were included in a systematic review process. All eligible studies were assured of methodological quality prior to data extraction. Data were extracted independently by three reviewers using a written protocol and standardized extraction documentation. Demographic and methodological characteristics of all included studies were initially reviewed and documented. A wide variety of fall risk factors were systematically reviewed including socio-demographic, medical, physical, clinical, psychological, behavioral and environmental factors, and medication use. Based on review, most risk factors were found to be significantly associated with fall occurrence. Moreover, strong associations were found for history of falls, gait problems, walking aids use, vertigo, and antiepileptic drug use. This systematic review identified evidence-based specific falls risk factors by confirming the multi-factorial etiology of falls. Hence, the major findings of this study guide the forthcoming intervention strategies for falls among community-dwelling older adults.
References
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Berry, S. D., & Kiel, D. P. (2016). Medication review after a fracture-absolutely essential. JAMA, 176(10), 1539-1540.
Berry, S. D., & Miller, R. R. (2008). Falls: epidemiology, pathophysiology, and relationship to fracture. Current Osteoporosis Reports, 6(4), 149-154.
Bird, M. L., Hill, K. D., Robertson, I., Ball, M. J., Pittaway, J. K., & Williams, A. D. (2013). The
association between seasonal variation in vitamin D, postural sway, and falls risk: an observational cohort study. Journal of Aging Research, 75(13), 1-6.
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Centre of Reviews and Dissemination. (2009). Systematic reviews: CRD’s guidance for undertaking reviews in health care. University of York.
Chu, L. W., Chi, I., & Chiu, A. Y. (2005). Incidence and predictors of falls in the chinese elderly. Ann Acad Med Singapore, 34(1), 60-72.
Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C., Negri, E. (2010). Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 21(5), 658-668.
Fuller, G. F. (2000). Falls in the elderly. American Family Physician, 61(7), 2173-2174.
Gunn, H., Creanor, S., Haas, B., Marsden, J., & Freeman, J. (2013). Risk factors for falls in multiple sclerosis: an observational study. Multiple Sclerosis Journal, 19(14), 1913-1922.
Hayashi, T., Kondo, K., Suzuki, K., Yamada, M., & Matsumoto, D. (2014). Factors associated with falls in community-dwelling older people with focus on participation in sport organizations: The Japan gerontological evaluation study project. Biomed Research International, 14, 1-10.
Hilliard, M. J., Martinez, K. M., Janssen, I., Edwards, B., Mille, M. L., Zhang, Y., & Rogers, M. W. (2008). Lateral balance factors predict future falls in community-living older adults. Archives of Physical Medicine and Rehabilitation, 89, 1708-1713.
Hubbard, G., Gorely, T., Ozakinci, G., Polson, R., & Forbat, L. (2016). A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking. BMC Family Practice, 17(73), 1-20.
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Kvelde, T., McVeigh, C., Toson, B., Greenaway, M., Lord, S. R., & Delbaere, K. (2013). Depressive symptomatology as a risk factor for falls in older people: systematic review and meta-analysis. Journal of the American Geriatrics Society, 61(5), 694-706.
Kuhirunyaratn, P., Prasomrak, P., & Jindawong, B. (2013). Factors related to falls among community dwelling elderly. Southeast Asian Journal Tropical Medicine Public Health, 44(5), 906-915.
Lin, C. H., Liao, K. C., Pu, S. J., Chen, Y. C., & Liu, M. S. (2011). Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations, Plos One, 6(4), 1-5.
Lin, F. R., Thorpe, R., Gordon-Salant, S., & Ferrucci, L. (2011). Hearing loss prevalence and risk factors among older adults in the United States. The Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 66(5), 582-590.
Lord, S. R., Ward, J. A., & Williams, P. (1994). Physiological factors associated with falls in older community-dwelling women. Journal of the American Geriatrics Society, 42, 1110-1117.
Mei O, Y., & El Fakiri, F. (2015). Gender differences in risk factors for single and recurrent falls among the community-dwelling elderly. SAGE Open, 21, 1-9.
Muir, S. W., Berg, K., Chesworth, B., Klar, N., & Speechley, M. (2010). Balance impairment as a risk factor for falls in community-dwelling older adults who are high functioning: a prospective study. Physical Therapy, 90(3), 338-347.
Patil, S. S., Suryanarayana, S. P., Dinesh, R., Shivraj, N. S., & Murthy, N. S. (2015). Risk factors for falls among elderly: A community based study. International Journal of Health and Allied Sciences, 4(3), 135-140.
Public Health Agency of Canada. (2014). Seniors’ falls in Canada: second report. Ottawa (ON): Public Health Agency of Canada.
Rubenstein, L. Z., Powers, C,, & MacLean, D. (2001). Quality indicators for the management and prevention of falls and mobility problems in vulnerable elders, Annals of internal Medicine, 135, 686-693.
Rubenstein, L. Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 35, 37-41.
Soriano, T. A., DeCherrie, L. V., & Thomas, D. C. (2007). Falls in the community-dwelling older: A review for primary-care providers. Clinical Interventions in Aging, 2(4), 545–553.
Steinberg, M., Cartwright, C., Peel, N., & Williams, G. (2000). A sustainable program to prevent falls and near falls in community dwelling older people: results of a randomized trial. Journal of Epidemiology and Community Health, 54(3), 227-232.
Talbot, L. A., Musiol, R. J., Witham, E. K., & Metter, E. J. (2005). Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health, 5(86), 1-9.
Tideiksaar, R. (2001). Falls in older persons. Prevention and management. 2nd ed. Baltimore: Health Professions Press.
Tinetti, M., Inouye, S., & Gill T. (1995). Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA, 273, 1348-1353.
USPSTF. (2012). Final recommendation statement falls prevention in older adults: counseling and preventive medication.
Vianda, S., Stel, J. H., Smit, S. M. F., & Pluijm, P. L. (2004). Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing, 33(1), 58-65.
Wells, G., Shea, B., & O’Connell, D. (2008). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. Available from: URL: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
W.H.O. (2007). WHO global report on falls prevention in older age. Ageing and Life Course Family and Community Health World Health Organization Avenue Appia, Geneva, Switzerland.
Bekibele, C. O., & Gureje, O. (2010). Fall incidence in a population of elderly persons in Nigeria. Gerontology, 56(3), 278-283.
Bergland, A. (2012). Fall risk factors in community-dwelling elderly people. Norsk Epidemiologi, 22(2), 151-164.
Berry, S. D., & Kiel, D. P. (2016). Medication review after a fracture-absolutely essential. JAMA, 176(10), 1539-1540.
Berry, S. D., & Miller, R. R. (2008). Falls: epidemiology, pathophysiology, and relationship to fracture. Current Osteoporosis Reports, 6(4), 149-154.
Bird, M. L., Hill, K. D., Robertson, I., Ball, M. J., Pittaway, J. K., & Williams, A. D. (2013). The
association between seasonal variation in vitamin D, postural sway, and falls risk: an observational cohort study. Journal of Aging Research, 75(13), 1-6.
Buracchio, T. J., Mattek, N. C., Dodge, H. H., Hayes, T. L., Pavel, M., Howieson, D. B., & Kaye, J. A. (2001). Executive function predicts risk of falls in older adults without balance impairment. BMC Geriatrics, 11(74), 1-7.
Centre of Reviews and Dissemination. (2009). Systematic reviews: CRD’s guidance for undertaking reviews in health care. University of York.
Chu, L. W., Chi, I., & Chiu, A. Y. (2005). Incidence and predictors of falls in the chinese elderly. Ann Acad Med Singapore, 34(1), 60-72.
Deandrea, S., Lucenteforte, E., Bravi, F., Foschi, R., La Vecchia, C., Negri, E. (2010). Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 21(5), 658-668.
Fuller, G. F. (2000). Falls in the elderly. American Family Physician, 61(7), 2173-2174.
Gunn, H., Creanor, S., Haas, B., Marsden, J., & Freeman, J. (2013). Risk factors for falls in multiple sclerosis: an observational study. Multiple Sclerosis Journal, 19(14), 1913-1922.
Hayashi, T., Kondo, K., Suzuki, K., Yamada, M., & Matsumoto, D. (2014). Factors associated with falls in community-dwelling older people with focus on participation in sport organizations: The Japan gerontological evaluation study project. Biomed Research International, 14, 1-10.
Hilliard, M. J., Martinez, K. M., Janssen, I., Edwards, B., Mille, M. L., Zhang, Y., & Rogers, M. W. (2008). Lateral balance factors predict future falls in community-living older adults. Archives of Physical Medicine and Rehabilitation, 89, 1708-1713.
Hubbard, G., Gorely, T., Ozakinci, G., Polson, R., & Forbat, L. (2016). A systematic review and narrative summary of family-based smoking cessation interventions to help adults quit smoking. BMC Family Practice, 17(73), 1-20.
Kalula, S. Z., Ferreira, M., Swingler, G. H., & Badri, M. (2016). Risk factors for falls in older adults in a South African urban community. BMC Geriatrics, 16(51), 1-11.
Kvelde, T., McVeigh, C., Toson, B., Greenaway, M., Lord, S. R., & Delbaere, K. (2013). Depressive symptomatology as a risk factor for falls in older people: systematic review and meta-analysis. Journal of the American Geriatrics Society, 61(5), 694-706.
Kuhirunyaratn, P., Prasomrak, P., & Jindawong, B. (2013). Factors related to falls among community dwelling elderly. Southeast Asian Journal Tropical Medicine Public Health, 44(5), 906-915.
Lin, C. H., Liao, K. C., Pu, S. J., Chen, Y. C., & Liu, M. S. (2011). Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations, Plos One, 6(4), 1-5.
Lin, F. R., Thorpe, R., Gordon-Salant, S., & Ferrucci, L. (2011). Hearing loss prevalence and risk factors among older adults in the United States. The Journal of Gerontology Series A: Biological Sciences and Medical Sciences, 66(5), 582-590.
Lord, S. R., Ward, J. A., & Williams, P. (1994). Physiological factors associated with falls in older community-dwelling women. Journal of the American Geriatrics Society, 42, 1110-1117.
Mei O, Y., & El Fakiri, F. (2015). Gender differences in risk factors for single and recurrent falls among the community-dwelling elderly. SAGE Open, 21, 1-9.
Muir, S. W., Berg, K., Chesworth, B., Klar, N., & Speechley, M. (2010). Balance impairment as a risk factor for falls in community-dwelling older adults who are high functioning: a prospective study. Physical Therapy, 90(3), 338-347.
Patil, S. S., Suryanarayana, S. P., Dinesh, R., Shivraj, N. S., & Murthy, N. S. (2015). Risk factors for falls among elderly: A community based study. International Journal of Health and Allied Sciences, 4(3), 135-140.
Public Health Agency of Canada. (2014). Seniors’ falls in Canada: second report. Ottawa (ON): Public Health Agency of Canada.
Rubenstein, L. Z., Powers, C,, & MacLean, D. (2001). Quality indicators for the management and prevention of falls and mobility problems in vulnerable elders, Annals of internal Medicine, 135, 686-693.
Rubenstein, L. Z. (2006). Falls in older people: epidemiology, risk factors and strategies for prevention. Age Ageing, 35, 37-41.
Soriano, T. A., DeCherrie, L. V., & Thomas, D. C. (2007). Falls in the community-dwelling older: A review for primary-care providers. Clinical Interventions in Aging, 2(4), 545–553.
Steinberg, M., Cartwright, C., Peel, N., & Williams, G. (2000). A sustainable program to prevent falls and near falls in community dwelling older people: results of a randomized trial. Journal of Epidemiology and Community Health, 54(3), 227-232.
Talbot, L. A., Musiol, R. J., Witham, E. K., & Metter, E. J. (2005). Falls in young, middle-aged and older community dwelling adults: perceived cause, environmental factors and injury. BMC Public Health, 5(86), 1-9.
Tideiksaar, R. (2001). Falls in older persons. Prevention and management. 2nd ed. Baltimore: Health Professions Press.
Tinetti, M., Inouye, S., & Gill T. (1995). Shared risk factors for falls, incontinence, and functional dependence. Unifying the approach to geriatric syndromes. JAMA, 273, 1348-1353.
USPSTF. (2012). Final recommendation statement falls prevention in older adults: counseling and preventive medication.
Vianda, S., Stel, J. H., Smit, S. M. F., & Pluijm, P. L. (2004). Consequences of falling in older men and women and risk factors for health service use and functional decline. Age Ageing, 33(1), 58-65.
Wells, G., Shea, B., & O’Connell, D. (2008). The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. Available from: URL: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm.
W.H.O. (2007). WHO global report on falls prevention in older age. Ageing and Life Course Family and Community Health World Health Organization Avenue Appia, Geneva, Switzerland.
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Published
2019-02-27
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Silpakampises, K., & Suwanwaha, S. (2019). Risk Factors Affecting Falls among Old Adults in Community: A Systematic Review. KASEM BUNDIT JOURNAL, 20(Feburary), 23–38. Retrieved from https://so04.tci-thaijo.org/index.php/jkbu/article/view/173417
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